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[Core Modules]

ePCR Telemedicine ED Consult

Some cases do not need a full hospital conveyance to benefit from specialist input.

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Some cases do not need a full hospital conveyance to benefit from specialist input.

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content/modules/epcr-telemedicine-consult.md

Last Updated

Apr 13, 2026

Category

Core Modules

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25d92d29ad75e76f

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modulesreal-time

Overview#

Some cases do not need a full hospital conveyance to benefit from specialist input. A remote crew may need emergency department advice before committing to destination, a rural service may need a rapid consultant view during transport, or a hear-and-treat decision may need clinical confirmation before the patient is left safely at home. Those decisions are time-sensitive and lose value if they require phone trees and manual callback.

The Telemedicine ED Consult module gives crews a live, encounter-linked consultation channel between the field and the receiving or supporting hospital team. It keeps the consultation inside the clinical workflow so advice, observations, and disposition decisions stay attached to the same encounter record that drove the call.

Diagram

flowchart TD
    A[Active Encounter] --> B[Consult Requested]
    B --> C[Target Hospital or Clinical Hub]
    C --> D[Live Audio and Video Session]
    D --> E[Shared Clinical Review]
    E --> F[Consult Notes and Advice]
    F --> G[Disposition or Destination Decision]
    G --> H[Encounter Record Updated]

Last Reviewed: 2026-04-13 Last Updated: 2026-04-13

Key Features#

  • Encounter-Linked Specialist Consults: Start a live consult from the active encounter so the clinical conversation stays attached to the patient episode rather than becoming a disconnected phone call.

  • Field-to-Hospital Video and Audio Review: Support real-time consultation between the responding crew and the receiving or supporting hospital clinician when visual context or live discussion changes the decision.

  • Hospital-Targeted Workflow: Route the consult to the hospital or service responsible for the patient pathway so the right team receives the request.

  • Live Observation Notes: Let participants add timestamped observations during the consult so the clinical conversation can be summarised back into the record.

  • Status-Based Session Handling: Make it clear whether a consult has been requested, connected, ended, or failed so crews are not left guessing whether advice is on the way.

  • Graceful Fallback Behaviour: Where telemedicine is not configured, the clinical workflow can show the feature as unavailable rather than breaking the encounter experience.

Use Cases#

  • Rural Emergency Department Advice: A crew in a remote region connects to the receiving ED for a rapid review before committing to a long transport.

  • Stroke or Trauma Escalation: A clinician initiates a live consult when a time-critical pathway would benefit from immediate hospital input during transport.

  • Hear-and-Treat Confirmation: A non-conveyance candidate is reviewed with a remote clinician so the service can support a safer community-based outcome.

  • Specialist Support for Borderline Cases: A field team uses the consult to validate a complex medication, destination, or escalation decision while the patient is still under active care.

  • Hospital Visibility Before Arrival: The receiving hospital gets more context than a static pre-alert when the crew needs to show or discuss what is happening in real time.

Integration#

  • Electronic Patient Care Report Clinical Workspace: Telemedicine sessions begin from the encounter and return their status and notes to the same clinical record.

  • Hospital Pre-Alert and Handover: Live consult complements pre-alert and handover by adding a real-time decision channel before arrival.

  • National or Regional Clinical Hub Workflows: Services can use the same consultation model for remote triage and specialist escalation programmes.

  • Destination and Pathway Management: Consultation outcomes can support destination selection, non-conveyance governance, and escalation decisions.

Open Standards#

  • W3C WebRTC: the consult uses the standard browser real-time communications model for live audio and video.

  • SDP Offer/Answer (RFC 3264): session establishment follows the standard negotiation pattern used across interoperable real-time communications systems.

  • ICE / STUN / TURN: network traversal relies on the standard mechanisms used for real-time media sessions across firewalls and mobile networks.

  • HTTPS / TLS: consult setup and session control remain inside the platform's secure web transport baseline.

  • JSON: consult metadata and observation updates move in a structured, interoperable payload format.